Regional Clinical Reimbursement Lead: PDPM & MDS Expert
STGi
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Benefits offered by this job
Job summary
STGi is seeking a Regional Clinical Reimbursement Consultant to lead MDS and PDPM oversight across multiple long-term care facilities in the Charlotte region. This role requires extensive travel and collaboration with clinical, financial, and operational leaders to optimize reimbursement while ensuring regulatory compliance.
The ideal candidate holds an active RN license with a BSN, 5–7 years of MDS and clinical reimbursement experience in long-term care, and strong knowledge of PDPM, RAI
Qualifications
- Active RN license in good standing
- BSN required
- 5–7 years of MDS and clinical reimbursement in long-term care
- Strong knowledge of PDPM, RAI Manual, ICD-10 coding, and CMS regulations
- Experience supporting audits and survey processes
- Ability to travel regularly within assigned region
Responsibilities
- Oversee clinical reimbursement operations across multiple skilled nursing facilities
- Ensure accurate, timely, and compliant MDS completion per CMS requirements
- Monitor PDPM performance, case-mix accuracy, and reimbursement trends
- Identify opportunities to optimize reimbursement while maintaining clinical integrity and compliance
- Provide guidance and oversight to MDS Coordinators and facility leadership
- Support MDS scheduling, CAAs, and care planning processes
- Lead corrective action plans related to MDS, documentation, and reimbursement findings
- Stay current on CMS updates, rule changes, and industry best practices
Skills
Education
Job description
STGi is seeking a Regional Clinical Reimbursement Consultant to lead MDS and PDPM oversight across multiple long-term care facilities in the Charlotte region. This role requires extensive travel and collaboration with clinical, financial, and operational leaders to optimize reimbursement while ensuring regulatory compliance.
The ideal candidate holds an active RN license with a BSN, 5–7 years of MDS and clinical reimbursement experience in long-term care, and strong knowledge of PDPM, RAI
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